CCMA Patient Care 2 — Questions and Answers

Question 1: When transferring a patient from a wheelchair to an examination table, the medical assistant should:

Lock the wheelchair wheels before beginning the transfer (Correct answer)
Leave the wheelchair unlocked for quick repositioning
Ask the patient to jump from the wheelchair to the table
Lift the patient without asking about their ability to assist

Correct answer: Lock the wheelchair wheels before beginning the transfer

Locking the wheelchair wheels before any transfer prevents the chair from rolling and causing the patient to fall.

Safe wheelchair-to-exam table transfer technique: (1) Position wheelchair at a slight angle to the exam table on the patient's stronger side; (2) Lock BOTH wheelchair wheels; (3) Raise or remove footrests; (4) Explain the procedure to the patient; (5) Ask the patient how much they can assist; (6) Assist the patient to stand, pivot, and sit on the exam table; (7) Use a gait belt if needed for support; (8) Use a two-person lift if the patient cannot bear weight. Never rush transfers — most patient falls occur during transfers.

Question 2: Which of the following is the FIRST step in the chain of infection?

Susceptible host
Portal of entry
Infectious agent (pathogen) (Correct answer)
Mode of transmission

Correct answer: Infectious agent (pathogen)

The chain of infection begins with the infectious agent — the pathogen (bacteria, virus, fungus, parasite) that can cause disease.

The chain of infection has six links: (1) Infectious agent (pathogen); (2) Reservoir (where the pathogen lives — human, animal, environment); (3) Portal of exit (how it leaves the reservoir — respiratory secretions, blood, feces); (4) Mode of transmission (contact, droplet, airborne, vector, vehicle); (5) Portal of entry (how it enters the new host — mucous membranes, broken skin, respiratory tract); (6) Susceptible host (person who can develop the disease). Breaking ANY link in the chain prevents infection. Standard precautions, sterilization, and isolation break multiple links.

Question 3: A patient complains of pain rated 8/10 on the numeric pain scale. Which action is appropriate?

Document the complaint and wait for the physician to notice it
Ignore the report because pain is subjective
Immediately notify the physician and document the report (Correct answer)
Administer an OTC analgesic without physician authorization

Correct answer: Immediately notify the physician and document the report

A pain rating of 8/10 is severe and requires immediate reporting to the physician for assessment and a treatment plan.

Pain is the fifth vital sign and must be assessed, documented, and communicated. A pain score of 7–10 is considered severe pain and should trigger immediate physician notification. The medical assistant should: (1) Document the patient's pain rating, location, quality, onset, duration, and aggravating/relieving factors; (2) Immediately notify the physician; (3) Prepare to assist with pain management as ordered; (4) Never administer medications without a physician's order. The numeric pain scale (0–10): 0 = no pain, 1–3 = mild, 4–6 = moderate, 7–10 = severe. Document using patient's own description.

Question 4: Which type of isolation precaution uses an N95 respirator for healthcare worker protection?

Contact precautions
Droplet precautions
Airborne precautions (Correct answer)
Protective (reverse) isolation

Correct answer: Airborne precautions

Airborne precautions require N95 (or higher) respirators because pathogens such as TB, measles, and varicella spread on small droplet nuclei that remain suspended in the air.

CDC Transmission-Based Precautions: (1) Contact precautions (gown + gloves): C. diff, MRSA, VRE, scabies; (2) Droplet precautions (surgical mask, eye protection within 3–6 feet): influenza, pertussis, meningococcal disease, COVID-19 (mask at minimum); (3) Airborne precautions (N95 respirator + negative pressure room): tuberculosis, measles (rubeola), varicella/disseminated zoster, SARS, monkeypox. N95 respirators filter ≥95% of airborne particles and must be fit-tested annually. Standard precautions (hand hygiene, gloves, gown, mask, eye protection, safe sharps) apply to ALL patients.

Question 5: When measuring urine output as part of intake and output (I&O) monitoring, the medical assistant should record the volume in:

Liters only
Milliliters (mL) (Correct answer)
Ounces only
Cubic centimeters converted to grams

Correct answer: Milliliters (mL)

Urine output and all fluid measurements in I&O monitoring are documented in milliliters (mL) using a calibrated measuring device.

Accurate I&O monitoring records all fluid intake (oral liquids, IV fluids, tube feedings) and all output (urine, emesis, drainage, stool if liquid) in milliliters. Normal adult urine output is 30 mL/hr minimum (0.5 mL/kg/hr) or approximately 1,500–2,000 mL/day. Output <30 mL/hr for 2+ consecutive hours suggests oliguria (inadequate renal perfusion) and requires immediate physician notification. All containers used to measure urine must be calibrated (e.g., urometer/urinal with mL markings) and wiped clean between uses. 1 oz ≈ 30 mL; 1 cup ≈ 240 mL for conversion reference.

Question 6: When positioning a patient for examination, Fowler's position refers to:

Patient lying flat on their back
Patient lying on their stomach
Patient sitting upright at 45–90 degrees, with head elevated (Correct answer)
Patient lying on their left side with knees drawn up

Correct answer: Patient sitting upright at 45–90 degrees, with head elevated

Fowler's position places the patient in a semi- to full-sitting position with the head of the bed elevated 45–90 degrees, facilitating breathing and cardiovascular and abdominal examinations.

Examination positions and their uses: Supine (dorsal recumbent) = lying flat, used for abdominal exam, general physical; Prone = face down, used for posterior exams; Fowler's = sitting 45–90°, used for cardiac, respiratory, and head/neck exams and patients with breathing difficulty; Lithotomy = supine with legs in stirrups, used for pelvic and gynecologic exams; Sims' = left lateral with upper knee flexed, used for rectal and sigmoid exams; Trendelenburg = supine with feet elevated, used for shock; Knee-chest = on hands and knees, used for rectal exams. Position the patient with modesty drapes applied.

CCMA Patient Care 2

When transferring a patient from a wheelchair to an examination table, the medical assistant should: